A teaching moment

This morning one of my readers gave me low rating: he had asked for advice about his heart pounding in his heart at night after heavy drinking. My advice included to stop (among many other things), but since he "already knew that", the rest of my consultation was useless to him. 

Apart from the fact that I don't really care about my rating, it is not unusual that patients don't want to hear the obvious. I remember a patient who came to my office for surgery  for his lung cancer, developed after a lifetime of smoking. He became very indignant with the suggestion that this could have anything to do with the tumor in his chest; after all, he had an uncle who had smoked much more and nothing ever happened to him! He even stopped smoking (almost) as soon as they took the chest X ray. He was one angry man, and very difficult to take care off after the surgery, ready to blame the world and me especially.

Similar situations happened other times with other patients/illnesses where the cause (smoking, eating, drinking etc.) had a direct connection with the result (cancer, coronary artery disease, obesity). "Shoot the messenger" is a situation that happens not infrequently in a doctor's office and is one of the challenges of taking care of patients. Strangely, this anger about being "done wrong by somebody" hardly ever seems to happen with those diseases that have no connection with bad personal habits!

Let me know what you think,

Dr T



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